Restored Cardiac Conditions and Left Ventricular Function After Parathyroidectomy in a Hemodialysis Patient-Parathyroidectomy Improves Cardiac Fatty Acid Metabolism Assessed by 123I-BMIPP

A 62 year-old female hemodialysis patient underwent parathyroidectomy to treat secondary hyperparathyroidism. On the preoperative assessment, the plasma levels of parathyroid hormone (PTH) and B-type natriuretic peptide (BNP) were elevated. Echocardiography showed reduced left ventricular (LV) contraction. Myocardial iodine-123-15-(p-iodophenyl)-3-(R,S) methylpentadecanoic acid (I-123-BMIPP) scintigraphy showed moderately reduced tracer uptake in the postero-inferior area on single-photon emission computed tomography and decreased washout on the planar images. After parathyroidectomy, the plasma levels of PTH and BNP decreased, followed by improvement in LV contraction. Myocardial I-123-BMIPP scintigraphy revealed that the washout on planar images had increased, which suggests that myocardial I-123-BMIPP scintigraphy is useful for estimating the effect Of parathyroidectomy on cardiac function. (Circ J 2009; 73: 1956-1960)